Introduction

• Cause: usually crush injury, eg road traffic accident, or penetrating abdominal wound.
• Signs: depends on organs involved but often abdominal pain and signs referable to hypovolemic shock.
• Diagnosis: history, radiography, ultrasonography, laparotomy.
• Treatment: supportive and may require surgical intervention.
• Prognosis: often good with appropriate treatment.

Pathogenesis

Etiology

• Traffic accident.
• Dog fights.
• Stabbing.
• Gunshot wound.

Pathophysiology

• Injury may involve any abdominal organ.

Urinary system

• Kidney rupture Kidney: trauma.
• Ureter avulsion Ureter: trauma.
• Ureter rupture Ureter: trauma.
• Bladder rupture Bladder: trauma rupture.
• Urethral rupture Urethra: rupture.

Liver

• Liver lobe rupture/hematoma Liver: trauma.
• Biliary tract rupture.

Spleen

• Rupture Spleen: trauma.
• Torsion.

Pancreas

• Pancreatitis Pancreas: trauma.

Gastrointestinal tract

• Rupture.
• Entrapment of intestines in torn mesentery.
• Mesenteric thrombosis.

Other

• Diaphragm rupture Diaphragm: traumatic hernia.
• Body wall rupture.

Timecourse

• If trauma is severe patient usually presents within hours of trauma.
• Peritonitis Peritonitis secondary to urinary or biliary tract leak may not present for days.

Diagnosis

Treatment

Outcomes